Effect of Aromatherapy Massage on Pain and Anxiety After Mastectomy

Breast cancer ranks first among the most common cancers in women in Turkey, and one out of every four women diagnosed in 2014 was breast cancer (Turkish Ministry of Health Public Health Institution, Turkey Cancer Statistics, 2017). Breast cancer is considered both a local and systemic disease. In the planning of the treatment, the decision of surgery is made by considering the stage of cancer, and the most frequently applied intervention is mastectomy, which involves the partial or complete removal of the breast tissue (Turkish Ministry of Health, General Directorate of Health Services. Breast Cancer Prevention, Screening, Diagnosis, Treatment, and Follow-up Clinical Guide, 2020; Tola et al., 2021). It is stated that in patients who have undergone breast surgery, especially during axillary lymph node dissection, due to the possibility of intercostobrachial nerve injury, pain, numbness, and weakness may be felt in the chest wall, arm, and shoulder in the postoperative period, acute/chronic, neuropathic and phantom pain, lymphedema may develop (Ozmen, 2012; Nemli et al., 2017). Post-operative pain decreases in the first few days, but in some patients, the severity of pain does not decrease or even increase despite post-operative pain management (Mc Mahon et al., 2013). Anxiety experienced by patients in the preoperative period, including breast cancer patients, is an important factor in the level of pain intensity felt after surgery (Stamenkovic et al., 2018; Kulkarni et al., 2017). Effective anxiety and acute pain management are important in terms of shortening the recovery period of the individual, reducing the treatment costs, preventing the occurrence of chronic pain, and increasing the quality of life. For this reason, it is mentioned that non-pharmacological methods can be used in addition to pharmacological treatment to assist treatment (Chou et al., 2016; Small and Laycock, 2020; Reisli et al., 2021). Today, it is known that aromatherapy has an important place among complementary and holistic therapy methods (Zor et al., 2021). However, it is stated that the studies on aromatherapy massage are weak in terms of evidence and more studies should be done on this subject (Ayik and Ozden, 2018). It is stated that aromatherapy oils are applied by inhalation method alone rather than applied with massage, there are few studies on the effectiveness of massage with aromatic oils, therefore more studies on aromatherapy massage should be done in the treatment of pain, anxiety, and depression (Crosby, 2018; Raffi, 2020).

It is seen that studies conducted after breast surgery are mostly focused on the development of chronic pain rather than acute pain intensity after surgery (Kulkarni et al., 2017). In the literature, the effects of aromatherapy massage on anxiety and acute pain severity in patients who are planning for breast surgery are examined, foot reflexology or classical massage (Dion et al., 2015) according to the massage area preferred by the patient in the postoperative period, classical massage applied to the chest region in the preoperative period (Dion et al., 2015). Xiao et al., 2018) there is research on interventions.

No clinical study was found that evaluated the severity of acute pain and anxiety level in the arm after Simple Mastectomy (SM) / Modified Radical Mastectomy (MRM) surgery with sesame oil, sesame-lavender oil mixture, and aromatherapy massage applied in the postoperative period. Therefore, the result of this study is important because it forms the basis for a clinical study.

With the results to be obtained from the research; It is aimed at better understanding the effects of these herbal-based agents in aromatherapy treatment, contributing to nurses' non-pharmacological treatment interventions, and providing quality care in the management of anxiety and acute pain in patients, and thus to provide new information to evidence-based nursing practices.